Why should we invest in health? Evidence from the lens of second-order benefits of health

Life expectancy and access to health care have both increased globally in recent decades, and these innovations have significantly improved well-being. As a result, health reforms are increasingly becoming a top concern in all countries in order to address/increase accessibility, affordability, and availability of quality services, as well as improve spending efficiencies. There are many evidenced benefits which are secondary to the health benefits of those programmes. However, second-order benefits of health schemes have received little attention and are rarely discussed in mainstream policy and practice. The paper intends to contribute to broader initiatives to recognise health schemes as vital in achieving equitable and inclusive development that benefits the entire community. The logical framework technique was used to analyse the health schemes' second-order benefits. The primary and secondary objectives, methods, outcomes, and impacts were compared. Apart from the health programmes’ own objectives, the analysis revealed extensive benefits such as employment opportunities, local partnerships with communities, decreased inequalities and population-level impacts on socio-economic development, women empowerment, increase in literacy and school completion rates, and decrease in out-of-pocket expenditure. The economic impact of investing in health systems by creating high-quality jobs and purchasing goods and services from local businesses is highlighted by the second-order health advantages, which are in relation to the primary benefits. Not only do healthcare systems play an important role in the economies of the nation, but also in the social lives of these communities

Prevalence of tobacco consumption among Auto Rickshaw Drivers in Chennai City, Tamil Nadu, India

Background Tobacco use is a major preventable cause of premature death and diseases. India is the second largest consumer of tobacco in the world. About 29% of adults use tobacco on a daily basis and an additional 5% use it occasionally. This study is contemplated with an aim to assess the prevalence of tobacco consumption and the associated factors involved in its consumption, as this group of the population is under constant pressure and account for the workforce of the country. Methods A Cross sectional descriptive study was conducted among Auto Rickshaw Drivers in Chennai City, who were working for more than two years and present on the day of examination and who were willing to participate in the study were included. Cluster random sampling technique was used. 400 samples were selected from 40 auto stands. Data was collected using a Survey Proforma which comprised of a Questionnaire which can assess the frequency of consumption, age of initiation, the amount of consumption, mental stress, economic factors, any past history of disease and most importantly the awareness towards oral cancer. Results Prevalence among auto rickshaw drivers for consumption of tobacco products was very high (87%). Auto rickshaw drivers were mostly used tobacco in the form of Gutkha (72%) and bidi (40%) in comparison to other products. It also shows that they use cheap tobacco products. Awareness level among auto rickshaw driver was high (70%) but still uses tobacco products because of its addiction (66%). In the opinion of auto rickshaw drivers increase in tax may reduce it consumption and the majority of drivers (70%) think that tobacco must be banned. Conclusions Prevalence of tobacco use among auto rickshaw drivers was very high. Many were suffering from tobacco related diseases like cough, ulcer on mouth, lung disorder. They are in definite need of tobacco cessation activities

An assessment of oral health status, tobacco use and cancer awareness among tea plantation workers (Irula tribes), Nilgiri Hills, Tamilnadu, India

Background Tea is an important agro-industry of India, which contributes immensely to the countries economy. Tea garden population constitutes approximately 1/12th of tea growing state´s population. Poor socio-economic conditions, ignorance due to illiteracy, over-crowded and unhygienic living conditions in the residential colonies make tea garden population vulnerable to various communicable diseases and malnutrition. Hence this study was contemplated with an aim to assess the oral health status, tobacco use and cancer awareness among tea plantation workers, Nilgiri Hills, Tamil Nadu, India. Methods A cross-sectional descriptive study was conducted to assess the tobacco use and cancer awareness among tea plantation workers, Nilgiri Hills.Data was collected using a pretested Questionnaire, which included Demographic data, tobacco habits, its frequency and form. The data collected was analysed using SPSS version15. Results Results showed that among 900 study population, showed 57% had no formal education, 34.5% had not visited dentist before. 64.5% had indigenous brushing habits. 52% of oral mucosal lesions and 6% malignant oral tumors were observed. A very high prevalence of periodontal disease, tobacco chewing, deep rooted beliefs and customs regarding dentition and dental treatment was observed in this community. Prevalence of oral mucosal lesions in the study population was due to tobacco usage and lack of awareness regarding the deleterious effects of the products used. Conclusions The dangers from smoking and chewing tobacco are well documented within the literature but the public's lack of knowledge of the risks is a concern. Health professionals are encouraged to ensure that the public is made aware of these risks, especially those within high-risk groups

Tobacco use, awareness and cessation among Malayali tribes, Yelagiri Hills, Tamil Nadu, India

Background Health is a state of complete wellbeing free from any discomfort and pain. Despite remarkable world-wide progress in the field of diagnostic, curative and preventive medicine. India has the second largest tribal population of the world next to the African countries. About half of the world's autochthonous people live in India, thus making India home to many tribes which have an interesting and varied history of origins, customs and social practices. The present study was conducted to assess the tobacco use, awarness and its effect on health among Malayali tribes, Yelagiri Hills, Tamil nadu, India. Methods The inhabitants of the 14 villages of the Yelagiri hills, who have completed 18years and residing for more than 15years present on the day of examination and who were willing to participate in the study were included. Data was collected from a cross-sectional survey, using a Survey Proforma, clinical examinationand a pre-tested questionnaire which included Demographic data, tobacco habits. An intra-oral examination was carried out by a single examiner to assess the Oral Health Status using WHO Oral Health Surveys - Basic Methods Proforma (1997).SPSS version15 was used for statistical analysis. Results Results showed that among 660 study population, 381(57.7%) had no formal education. Among the study population 75%) had the habit of alcohol consumption. Of those who had the habit of smoking, 26% smoked beedi, 10.9% smoked cigarette, 65% chewed raw tobacco, 18% chewed Hans and 28% had a combination of smoking and smokeless tobacco usage. Prevalence of oral mucosal lesions was very high. Conclusions From the results of this study it may be concluded that the Malayali tribes were characterized by a lack of awareness about oral health, deep rooted dental beliefs, high prevalence of tobacco use and limited access to health services

Relationship of obesity with periodontitis among patients attending a dental college in Chennai: A cross-sectional survey

Introduction: Periodontal disease is a global public health issue, and it has been suggested to be an associated risk factor for obesity. However, the studies addressing these relationships were sparse. Aim: This study aims to determine whether there was a relationship between body mass index (BMI) and periodontal disease. Materials and Methods: This cross-sectional study was carried out on 400 individuals who were randomly selected from the outpatient department of a dental college in Chennai. The community periodontal index (CPI) was used to assess periodontal status. Participants with a CPI score (CPI 0–2) were considered as nonperiodontitis group and those with a CPI score (CPI 3–4) were considered to have periodontitis. Statistical analysis was performed using Chi-square test and logistic regression analysis was used to estimate the association between BMI and periodontitis. P < 0.05 was considered as statistically significant. Results: The prevalence of periodontitis was 29.2% with a mean BMI score of 22.45 ± 05.27. Logistic regression analysis revealed a 30% increased risk for periodontitis per 1-kg/m2 increase in BMI (adjusted odds ratio, 1.30; 95% confidence interval, 1.08–1.27; P < 0.05). Conclusion: Periodontal disease was associated with increased BMI establishing a link between obesity and periodontitis

Knowledge about causes and prevention of oral diseases among higher secondary school students in Vellore District, Tamil Nadu, India: A cross-sectional survey

Background: Awareness regarding oral diseases and its prevention aids in the development of correct oral health practices, thereby controlling oro-dental problems; hence, this study aimed to evaluate the level of oral health knowledge pertaining to its causes and prevention among higher secondary school students in Walajapet, Vellore district, India. Materials and Methods: The survey was carried out among 400 schoolchildren who were in the age group of 16–18 years studying in various schools of Walajapet in Vellore district. Data on knowledge about oral diseases were collected by means of self-administered questionnaire. The results were analyzed by descriptive statistics and Chi-square test using Statistical Package for the Social Sciences version 19. P < 0.05 was considered statistically significant. Results: A total of 400 secondary school students with an age range of 16–18 years and mean age of 17.2 ± 10.44 years participated in the study. About 324 (81.0%) secondary school students had adequate level of knowledge on causes and prevention dental caries, 267 (66.7%) school students were aware of causes and prevention of periodontal diseases, only 195 (48.7%) school students had awareness on cause and prevention of oral cancer, and 305 (76.2%) students were familiar with causes and prevention of dental malocclusion. Conclusion: Majority of schoolchildren showed adequate knowledge toward causes and prevention of dental caries, periodontal disease, and dental malocclusion but had inadequate knowledge toward oral cancer

Envelope coronally advanced flap with site‐specific bilaminar acellular dermal matrix or connective tissue graft for management of multiple marginal tissue recessions: a retrospective analysis of cases

Background A proper case selection and decision making is essential for management of multiple marginal tissue recessions (MTR) using a conventional or bilaminar approach. Coronally advanced flap (CAF) is one of the commonly used methods for management of MTR. CAF has been advocated in combination with soft tissue grafts as bilaminar technique, which had showed significant success in terms of root coverage. Methods and Results Aim of this case series was to retrospectively evaluate Zucchelli's modification of envelope CAF (eCAF) and site-specific bilaminar methods using Acellular Dermal Matrix (ADM) and Connective Tissue Graft (CTG) for management of MTR. A total of 15 subjects (five subjects/25 sites per technique, total number of sites = 75) who were managed by three different techniques with 12 months postoperative records were retrospectively evaluated. All patients showed significant clinical improvement in root coverage outcomes when compared to baseline. Mean root coverage achieved at 3 months (90%), 6 months (95%) and 12 months (95%) postoperatively did not reveal significant difference between three methods. Complete root coverage was observed in 86.6% of eCAF cases and in 86.6% and 95% of ADM/CTG with eCAF, respectively. There was an increase in width of keratinised tissue, both individually and collectively across all of the groups. Conclusion Clinical outcomes suggested that bilaminar techniques should be used only in specific cases. Predictable results can be obtained without the use of a soft tissue graft or substitute if a careful treatment plan for technique selection is developed on an individual case-by-case basis